Individual provider Active NPI

Cynia Black, LCSW-A

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1992379473
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P014010 Issued in NC
Practice address
3400 Croasdaile Dr
Durham, NC 27705-6815
Phone
(919) 321-0084
NPI assigned
May 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P014010 NC Primary

Addresses

Primary practice location

3400 Croasdaile Dr
Durham, NC 27705-6815

Mailing address

600 E B St Apt L2
Butner, NC 27509-2460
Phone (919) 685-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P014010NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1992379473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E B ST APT L2",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275092460",
            "telephone_number": "919-685-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CROASDAILE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056815",
            "telephone_number": "919-321-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CYNIA",
        "name_prefix": "Ms.",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.